MANAGEMENT OF SUBCLAVIAN-AXILLARY VEIN-THROMBOSIS - A REVIEW

OBJECTIVE: To study, by literature review, the management of subclavia n-axillary vein thrombosis (SAVT) and to make recommendations. DATA SO URCES: The MEDLINE database and cross-referenced articles. STUDY SELEC TION: Key words subclavian-axillary vein thrombosis, venous thrombosis , Paget-Schroetter syndrome, anticoagulation, and thrombolysis were us ed to extract articles related to SAVT. DATA EXTRACTION: Independent e xtraction of articles by 2 observers. DATA SYNTHESIS: Although numerou s studies are available in the literature, they vary widely in their p atient selection, treatment methods, follow-up and conclusions. As suc h, the management of patients with SAVT remains controversial.CONCLUSI ONS: Anticoagulation remains the initial treatment of choice for acute SAVT although there is definitely a role for thrombolysis and surgery in selected cases. Surgical intervention should be reserved for patie nts in whom there is a specific indication. Since chronic symptoms dep end largely on the etiology of the disease, treatment should be tailor ed to address the causative factors. A multicentre, prospective study is necessary to evaluate the optimum management strategies for patient s with SAVT.